Academic-community collaboration. An ecology for early childhood violence prevention.

The growing supportive evidence for multi-faceted approaches to violence prevention certainly demand that multi-agency collaborations will continue to proliferate as communities engage in early childhood prevention strategies. These collaborations often include partnerships between members of academia and community agencies that often produce unique challenges and benefits related to diverse experiences, skills, agendas, and practical constraints. This article describes the Jacksonville First and Best Teacher Initiative, an example of one such collaborative model for violence prevention, to illustrate many of the principles of effective academic-community collaborations and lessons learned in addressing the specific challenges of such programs.

Examining a stress-coping model of burnout and depression in extension agents.

Occupational stressors, coping strategies, and burnout and depression were examined in extension agents. Results indicated that a significant proportion of extension agents (range = 9.8%-51%) reported burnout symptoms above established cut-off scores for the burnout subscales, but fewer than 3% of the sample reported significant symptoms on all 3 dimensions of burnout. Depressive symptoms based on established cut-off scores were noted in approximately 26% of the sample. Stepwise multiple regression indicated that extension agents who used an emotion-oriented coping strategy were more likely to (a) display high levels of depression, emotional exhaustion, and depersonalization and (b) exhibit low levels of personal accomplishment. Furthermore, task-oriented coping strategies were found to be negatively associated with the 3 dimensions of burnout. Implications for interventional programming to reduce the symptoms of burnout are discussed.

Extramedullary disease in acute promyelocytic leukemia.

All-trans retinoic acid (ATRA) is currently recommended as standard treatment for acute promyelocytic leukemia (APL). However there has been increasing concern that ATRA is associated with unusual sites of relapse. Although there is insufficient evidence so far to substantiate this, we review the potential mechanisms by which ATRA may increase the incidence of extramedullary and, in particular, central nervous system (CNS) relapse.

Anterograde tracing of trigeminal afferent pathways from the murine tooth pulp to cortex using herpes simplex virus type 1.

Due to its predominantly nociceptive innervation, viral tracing from the tooth pulp provides a potential means for tracing central pain pathways. The neural pathways from the tooth pulp to cortex were determined using in situ hybridization to detect the anterograde transneuronal spread of herpes simplex virus type 1 strain H129 following inoculation into the murine mandibular incisor pulp. Virus first appeared in the brain at day 3 in the dorsomedial region of all three subnuclei of the spinal trigeminal nucleus and the principal sensory nucleus. By days 5-6 virus had spread to the contralateral medial nucleus of the medial geniculate complex, posterior thalamus, and ventroposteromedial thalamus. At days 7-8 virus was detected in laminae IV and Va of the primary somatosensory cortex and lamina IV of the secondary somatosensory cortex in regions previously shown to receive input from the lower jaw. Several mice also showed infection of laminae II/III of the ipsilateral dysgranular insular cortex, along with labeling for virus in the ipsilateral external lateral parabrachial nucleus, posterior thalamus, and posterior basolateral amygdala. Our results are highly consistent with previous tracing and electrophysiological studies utilizing the tooth pulp and with studies implicating the infected structures in nociception. Viral spread appeared to define two separate afferent systems with infection of structures which have been implicated in the sensory-discriminative aspects of pain, such as the ventroposteromedial thalamus and somatosensory cortex, as well as in the dysgranular insular cortex and related subcortical nuclei which may have a role in the affective-motivational aspects of pain.

Coronavirus-induced demyelination occurs in the presence of virus-specific cytotoxic T cells.

C57BI/6, but not BALB/c, mice infected with mouse hepatitis virus strain JHM (MHV-JHM) develop a late onset, symptomatic demyelinating encephalomyelitis. In this report, we characterized anti-viral cytotoxic T cells in the central nervous system and spleen during the acute and chronic stages of the MHV infection. The data show that C57BI/6 mice display a cytotoxic T cell (CTL) response to the surface (S) glycoprotein and this response can be demonstrated in lymphocytes isolated from the brains and spinal cords of mice both acutely and persistently infected with MHV-JHM. Thus, the anti-S CTL activity present in the central nervous system of chronically infected animals is not sufficient to prevent the demyelinating process. BALB/c mice have been shown previously to mount a CTL response against the nucleocapsid (N) protein (Stohlman et al., 1992). Since C57BI/6 mice do not mount a response to the N protein, the role of the N-specific response in preventing the late onset disease was assessed using B10.A(18R) mice, recombinant in the H-2 locus. These mice contain the d alleles of the D and L loci and exhibit a CTL response against the N protein. However, unlike the BALB/c mice, these animals develop the late onset symptomatic disease. These results suggest that the N-specific response is partially protective against the development of the demyelinating disease, but that additional factors are also likely to be involved.

Epidemiology of school injuries: a 2-year experience in a municipal health department.

School injuries occurring in a municipal school system during a 2-year period were reviewed to identify epidemiologic features of school injuries, to determine data requirements for ongoing injury surveillance, and to identify potential preventive strategies. Overall, 3,009 injuries were reported (2.82/100 students per year). Elementary school students had only a slightly higher rate (2.85) than secondary school students (2.78). However, the cause, nature, school location of injury, and body area injured formed distinct patterns in these two groups. Playgrounds were responsible for the highest overall and elementary school rates, whereas sports areas and classrooms had the highest rates among secondary school students. Falls were the most frequent cause of injury in elementary schools whereas, as expected, sports injuries were the most frequent cause among secondary school students. Contusions and abrasions of the head were the most frequent type of injury for both groups, although more common among elementary school students, whereas fractures, sprains, strains, and dislocations were more frequent among secondary school students. Although the proportion of severe injuries to secondary school students was slightly higher (39 v 35%), the rate of referral of students to a hospital or physicians among secondary school students (1.21 per 100 student-hours) was almost twice the rate of elementary school students (0.65 per 100 student-hours). Problems with definition of injury severity and the need to explore the social aspects of schools as a factor in injuries emerged as important considerations for future research.

The epidemiology of school injuries: the problem of measuring injury severity.

In the few surveys of injuries occurring in schools, severity has been defined using a priori criteria based on the nature of injury and by the area injured. The validity of these methods of classifying injury severity has not been established. The association between two commonly used measures of injury severity (nature of injury and body area injured) with referral to medical assessment was explored, based on a simple model derived from the literature. Kendalls Tau-b was used to assess the association between the indicators of injury severity and referral; controlled for both school level (elementary school and secondary school) and the degree of behavioural control that could be exerted in the location of the injury. There was a very low association between indices of injury severity and referral for medical assessment regardless of level of school or degree of behavioural control. It is concluded that the simple model derived from the literature does not adequately describe the relationship between injury severity and referral in the school setting. The major issue facing school staff is not the measurement of injury severity per se, but the appropriate referral of the injured child for medical assessment and treatment.